NPIMap

Individual provider Active NPI

Hamid Reza Djalilian, M.D.

  • Otology & Neurotology Physician
  • Orange, CA
National Provider Identifier
1750331179
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
A85665 Issued in CA
Practice address
101 The City Dr S
BLDG 56, Suite 500 Rte 81
Orange, CA 92868-3201
Phone
(714) 456-5753
Fax
(714) 456-2280
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X A85665 CA Primary

Addresses

Primary practice location

101 The City Dr S
BLDG 56, Suite 500 Rte 81
Orange, CA 92868-3201

Mailing address

101 The City Dr S
BLDG 56, Suite 500 Rte 81
Orange, CA 92868-3201
Phone (714) 456-5753

Other identifiers 1

IdentifierTypeStateIssuer
00A856650MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050202000871 CA Practitioner - Otolaryngology 3375594765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Minnesota Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Head and Neck SurgeonsGroup PAC ID 9032191788, 25 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-5731

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
85665CAMDPharmacist
A85665CAMDOtology & Neurotology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tbi Virtual Current Accepting new patients
University Head & Neck Surgeons CurrentSince May 1, 2006 Accepting new patients
Neuromed Clinic, LLC Current Accepting new patients
University of California Irvine Past Accepting new patients
University of Minnesota Physicians Past Accepting new patients
Paparella Ear Head & Neck Institute PA PastSince Apr 1, 2016 Accepting new patients
University of California Irvine Past Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 56
Orange, CA 92868
Phone (714) 456-5753

101 The City Dr S
Bldg 25
Orange, CA 92868
Phone (714) 456-5731

101 The City Dr S
Bldg 30A
Orange, CA 92868

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1750331179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "BLDG 56, SUITE 500 RTE 81",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5753",
            "fax_number": "714-456-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "BLDG 56, SUITE 500 RTE 81",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5753",
            "fax_number": "714-456-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJALILIAN",
        "first_name": "HAMID",
        "middle_name": "REZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "CA",
            "license": "A85665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A856650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.